As many as 15,000 patients in Vancouver could see dramatic changes in how they receive medical care during the next year if Vancouver Coastal Health moves ahead with changing how five community health centres are operated.

Within the next six to 12 months, the equivalent of seven full-time physicians working at Pacific Spirit, South Vancouver and Evergreen clinics will be transferred to a new, centralized clinic on Ontario Street.

While the equivalent of four physicians will remain at Mid Main, changes to that clinic’s interdisciplinary team may put in jeopardy various programs, including home visits to the frail elderly.

At Pine Clinic, the equivalent of 2.5 full-time physicians are being shifted to three other city health centres on the east side.

The five clinics are all publicly funded by Vancouver Coastal Health. Each one serves a different mix of patients. According to VCH, Evergreen and Pacific Spirit are similar to walk-in clinics that serve a range of patients, from those considered at risk to those who could be served by traditional family physicians. Pine Clinic was originally intended to serve at-risk youths, but now also has adults as patients.

Dr. David Hall, the medical director of primary care for VCH, said the proposed changes are meant to focus resources on those who are the most vulnerable.

“We’re not closing services per se,” he said. “We’re realigning our services. We’re working with the physicians right now to determine what services will remain.”

If physicians at the affected clinics shift to being funded directly by the Medical Services Plan rather than through VCH, he said, services will continue and patients won’t notice a difference.

“If the physicians decide to transition to fee-for-service and continue, then their doctor and clinic is ongoing, so they are walking through the same door and seeing the same person,” Hall said when asked what difference, if any, patients may notice.

“We have a commitment to ensure that service continues for all the patients who are getting care with us.”

Hall said the goal is to move patients with lower needs into the care of family physicians. Those with high needs will be getting centralized treatment at the Primary Care High Needs Stabilization Clinic at the Raven Song Community Health Centre at 2450 Ontario Street. Slated to open later this year, it will be able to help people seven days a week, 12 hours a day.

“I think people are generally stressed during times of change,” Hall said. “It can be difficult for anyone who is in the midst of change. I think people are very connected to their primary-care physicians — their family doctors. We’re trying to respect and preserve and support that as best as we can.”

Primary care is community-based care provided by health-care professionals including family physicians, nurse practitioners and community nurses.

As youth services are decreased at Pine Clinic, VCH plans to increase such services at Raven Song, Three Bridges Primary Care Clinic in downtown Vancouver, and at the East Van Public health Youth Clinic at the Robert and Lily Lee Family Community Health Centre at Broadway and Commercial.

The proposed service reductions were criticized Tuesday at a news conference held in front of the Evergreen Community Health Care Centre near the Joyce Street SkyTrain Station in East Vancouver.

Provincial NDP leader Adrian Dix said closing primary care at Evergreen, South Vancouver and Pacific Spirit clinics will send more people to acute care hospitals.

Dix said it doesn’t make sense to force people to look for a family doctor in a city where 27,000 people are actively looking for one.

He said the provincial government was making “a terrible decision” that won’t save money.

“These centres work remarkably well,” he said. “They provide excellent multidisciplinary care. They support and ensure that people don’t end up in acute care hospitals. They’re the last things that should be cut by the government.”

“The government says this is not about a cut,” Darcy said. “They say it is about re-prioritizing. But it is absolutely about a cut to primary care — quality preventive care to thousands and thousands of people in this community.”

Chris Taulu, a Collingwood community activist for 40 years, said she and her husband are patients at Evergreen. Even though Vancouver Coastal Health was supposed to consult with the community before making any changes, Taulu said it didn’t. She found out about its plans from her doctor a couple of weeks ago.

Taulu is executive director of the Collingwood Community Policing Centre.

Taulu who described her age as in the late 70s said she had recently been diagnosed with pulmonary thrombosis — a blood clot in the lungs. Interviewed after the news conference, she said she doesn’t know if she fits the criteria as a patient in the new centralized Stabilization Clinic at Raven Song at Broadway and Ontario.

“They’re absolutely phenomenal here,” she said about the doctors at Evergreen. “They’re fantastic about taking care of you. I have to start thinking: ‘I’m not going to find a doctor for October.’ I can get to Raven Song but can other people?”

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